Corina L Rolfast, Erik J Lust, Carel C de Cock Critical Care 2012, 16:R100 (6 June 2012)
Introduction: During therapeutic hypothermia (TH) ECG abnormalities such as Osborn waves and/or ST segment elevation have been described. However, the incidence and prognostic value of these ECG changes are uncertain given the small-scale studies that have been carried out to date. The aim of this study is to further evaluate the electrocardiographic changes during therapeutic hypothermia.
Methods: During a period of 3 years 81 patients (age 63 +/- 14 years) were included retrospectively. All patients underwent therapeutic hypothermia after being resuscitated. ECG registrations before, during and after TH were collected and analyzed. Patients were divided into 2 groups based on the presence or absence of transmural ischemia ST elevation on the first representative ECG upon arrival at the hospital (STEMI and non-STEMI).
Results: A total of 243 electrocardiograms were analyzed. During TH 24 patients (30%) had Osborn waves that disappeared in 22 patients (92%) after regaining normal body temperature. The presence of Osborn waves was not associated with age, gender, average pH, electrolytes, or lactate levels and was not associated with excess in-hospital mortality. In 10 patients (12%, 6 non-STEMI patients) new STEMI was observed during TH, which disappeared after TH discontinuation. The STEMI group (44 patients) had significantly more Osborn waves during TH than the non-STEMI group (38.6% vs. 15.2%, 0R 3,508; 95% CI 1,281-9,610).
Conclusions: Hypothermia induced Osborn waves are relatively common and are not associated with an unfavorable short-term outcome. Therapeutic hypothermia is associated with ECG changes that may mimic STEMI.
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